Student of Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia.
Department of Pharmacology, Riga Stradins University, LV-1007 Riga, Latvia.
Medicina (Kaunas). 2023 Oct 11;59(10):1810. doi: 10.3390/medicina59101810.
: The COVID-19 pandemic caused by the Coronavirus SARS-CoV-2 is a complex challenge for the existing scientific and medical landscape. It is an ongoing public health crisis, with over 245,373,039 confirmed cases globally, including 4,979,421 deaths as of 29 October 2021. Exploring molecular mechanisms correlated with the disease's severity has demonstrated significant factors of immune compromise, noted in diabetic patients with SARS-CoV-2 infections. Among diabetics, the altered function of the immune system allows for better penetration of the virus into epithelial cells, increased viral binding affinity due to hyperglycemia, reduced T cell function, decreased viral clearance, high risks of cytokine storm, and hyper-inflammatory responses, altogether increasing the susceptibility of these patients to an extreme COVID-19 disease course. This research involved a systematic literature search among various databases comprising PubMed and Google Scholar in determining credible studies about the effects of antidiabetic drugs on the high mortality rates among diabetic patients infected with COVID-19. The primary search found 103 results. Duplicated results, non-pertinent articles, and the unavailability of full text were excluded. Finally, we included 74 articles in our review. The inclusion criteria included articles published during 2020-2023, studies that reported a low risk of bias, and articles published in English. Exclusion criteria included studies published in non-peer-reviewed sources, such as conference abstracts, thesis papers, or non-academic publications. Among the studied anti-diabetic drugs, Metformin, the Glucagon-like peptide 1 receptor agonist (GLP-1RA), and Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) have demonstrated decreased mortality rates among diabetic patients infected with COVID-19. Insulin and Dipeptidyl peptidase 4 inhibitors (DPP-4i) have demonstrated increased mortality rates, while Sulfonylureas, Thiazolidinedione (TZD), and Alpha-glucosidase inhibitors (AGI) have demonstrated mortality-neutral results.
由冠状病毒 SARS-CoV-2 引起的 COVID-19 大流行对现有的科学和医学领域来说是一个复杂的挑战。这是一场持续的公共卫生危机，截至 2021 年 10 月 29 日，全球已确认病例超过 24537.3039 万例，包括 497.9421 例死亡。探索与疾病严重程度相关的分子机制表明，免疫功能受损是一个重要因素，在感染 SARS-CoV-2 的糖尿病患者中可以观察到这一点。在糖尿病患者中，免疫系统功能的改变使得病毒更容易穿透上皮细胞，高血糖导致病毒结合亲和力增加，T 细胞功能下降，病毒清除减少，细胞因子风暴和炎症反应风险增加，这些因素共同增加了这些患者发生严重 COVID-19 疾病的易感性。这项研究涉及在 PubMed 和 Google Scholar 等各种数据库中进行系统文献检索，以确定有关抗糖尿病药物对 COVID-19 感染糖尿病患者高死亡率影响的可信研究。初步搜索发现了 103 项结果。排除了重复的结果、不相关的文章和无法获取全文的文章。最终，我们在综述中纳入了 74 篇文章。纳入标准包括 2020-2023 年发表的文章、报告低偏倚风险的研究以及发表在英语期刊上的文章。排除标准包括发表在非同行评议来源（如会议摘要、论文或非学术出版物）的研究。在所研究的抗糖尿病药物中，二甲双胍、胰高血糖素样肽 1 受体激动剂 (GLP-1RA) 和钠-葡萄糖共转运蛋白 2 抑制剂 (SGLT-2i) 已被证明可降低 COVID-19 感染的糖尿病患者的死亡率。胰岛素和二肽基肽酶 4 抑制剂 (DPP-4i) 已被证明可增加死亡率，而磺酰脲类、噻唑烷二酮 (TZD) 和 α-葡萄糖苷酶抑制剂 (AGI) 则显示出死亡率中性结果。
